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Blood Pressure Management After Successful Thrombectomy
Despite the success of endovascular therapy (EVT) in acute ischemic stroke due to large vessel occlusion, opportunities to further optimize clinical outcomes remain. One such avenue is to reduce hemorrhagic transformation in the infarcted tissue bed after successful reperfusion, which has been shown to be associated with worsened clinical outcomes. Because higher cerebral perfusion pressures may foster hemorrhagic transformation, it has been hypothesized that lowering systemic blood pressure (BP) after successful reperfusion could decrease cerebral hemorrhagic complications. Reducing systemic BP may also lead to a decrease...
Source: JAMA - September 5, 2023 Category: General Medicine Source Type: research

Extracranial-Intracranial Bypass Surgery for Stroke Prevention
The concept of performing an extracranial-intracranial (EC-IC) arterial bypass operation for a patient with an internal carotid artery (ICA) or middle cerebral artery (MCA) occlusion is intuitively appealing. In these patients, it is believed that areas of hypoperfusion exist and anastomosis of the superficial temporal artery to the MCA is designed to augment brain perfusion. In vascular territories outside of the brain, bypass procedures performed to augment arterial flow typically improve clinical outcomes. For reasons unknown, however, the brain appears to respond differently to bypass surgery.
Source: JAMA - August 22, 2023 Category: General Medicine Source Type: research